Experience MedEx Seamless Care Delivery — 10% OFF on Your First Appointment - Use 'TRYMEDEX' Coupon Code on Checkout //////////////////////////////////// General Price List — Consultation: 750 THB | Home Lab Test Service Fee: 750 THB (FREE for Orders Over 5,000 THB)
MedEx is a one-stop destination when it comes to medical tourism and digital specialized health care services. MedEx serves as a connector between patients and trusted world-class health service providers.
Hormone testing guide · 2026
SHBG rarely gets ordered on its own, and it rarely should be. Its value is in what it does to the interpretation of every other sex hormone on the report.
Sex hormone binding globulin (SHBG) is a liver-produced protein that binds testosterone and estradiol in the bloodstream, controlling how much is available to tissue. Because of that, an SHBG result reframes the total testosterone or total estradiol sitting next to it. Low SHBG — typical in obesity, insulin resistance, hypothyroidism and with anabolic steroid use — makes total testosterone read lower than the functional reality. High SHBG — typical in ageing, hyperthyroidism, liver disease and oestrogen therapy — does the reverse.
| Sample | Blood draw; pair with total testosterone and albumin |
|---|---|
| Best ordered | Alongside testosterone or estradiol, not in isolation |
| Lowered by | Obesity, insulin resistance, hypothyroidism, androgens, corticosteroids |
| Raised by | Ageing, hyperthyroidism, liver disease, oestrogen, some anticonvulsants |
| Collection | At home in Bangkok or at 20+ MedEx sites nationwide; nurse-at-home draw available |
| Price | Listed on the MedEx lab test catalogue — same price nationwide |
SHBG binds sex steroids with high affinity and acts as a circulating reservoir and regulator. When SHBG rises, a larger share of testosterone is held in an unavailable form; when it falls, more is released. The total hormone concentration in the tube may not change much in either case — but the biological effect does.
This is why an isolated total testosterone can send someone down the wrong path. It is also why SHBG belongs in the same draw rather than as an afterthought once the first result confuses everyone. Both can be added from the MedEx lab test catalogue.
| Lowers SHBG | Obesity and central adiposity, insulin resistance and type 2 diabetes, non-alcoholic fatty liver disease, hypothyroidism, exogenous androgens and anabolic steroids, glucocorticoids, growth hormone excess, nephrotic syndrome |
|---|---|
| Raises SHBG | Increasing age, hyperthyroidism, cirrhosis and chronic hepatitis, oestrogen therapy and combined oral contraceptives, pregnancy, anorexia and marked weight loss, HIV, some anticonvulsants |
Notice how many entries are metabolic. A low SHBG is one of the more consistent laboratory signals of insulin resistance, and has been studied as a predictor of incident type 2 diabetes. If yours is low, glucose and HbA1c are worth adding — and the MedEx metabolic and weight service is the more useful destination than a hormone clinic.
Add SHBG to your testosterone or estradiol draw — same sample, no extra visit.
In men with borderline testosterone. SHBG plus albumin allows a calculated free testosterone, which usually resolves whether a low-normal total is meaningful.
In women being assessed for PCOS. A low SHBG raises the free androgen index even when total testosterone is unremarkable, and often correlates with the metabolic component of the syndrome.
In people on hormonal contraception or oestrogen. SHBG typically rises substantially, lowering free testosterone. This is a recognised contributor to reduced libido in some users and is worth measuring rather than assuming.
In thyroid disease. SHBG tracks thyroid status, so an unexplained value should prompt a look at TSH and free T4 in the same draw.
SHBG on its own answers almost nothing. Order it as part of a combination:
All of these run from a single sample. Compare available biomarkers in the lab directory, or ask the team to assemble a panel around your question through MedEx functional lab testing.
Most often it reflects insulin resistance, central weight gain or fatty liver, and it can also follow androgen or corticosteroid use and hypothyroidism. It makes total testosterone read lower than the functional reality, so a calculated free testosterone is helpful.
Common causes include ageing, hyperthyroidism, liver disease, oestrogen therapy or combined oral contraceptives, marked weight loss and some anticonvulsants. It makes total testosterone read higher than the functional reality.
Rarely. Its value lies in reframing a testosterone or estradiol result measured on the same sample, so order them together.
Combined hormonal contraceptives typically raise SHBG substantially, which lowers free testosterone. This is one recognised contributor to reduced libido in some users.
SHBG is comparatively stable, but since it is usually drawn with testosterone, use the same 8-10am fasted morning slot for consistency.
Low SHBG usually points at metabolism, not hormones.
Medical disclaimer: This article is general health information and does not replace medical advice, diagnosis or treatment. Laboratory reference ranges differ between laboratories and results must be interpreted alongside your symptoms, medicines and medical history. Speak with a qualified clinician before starting, stopping or changing any treatment. Service details, inclusions and prices can change — confirm them with MedEx before booking.
How luteinising hormone is used to time ovulation, what the LH to FSH ratio means in PCOS, and how blood LH differs from urine ovulation kits.
The difference between sensitivity, specificity and positive predictive value in NIPT, and why a high-risk result is often not what it appears.
Why M. genitalium requires macrolide resistance testing, who should be tested, and why asymptomatic screening is not recommended.
Find quality services, specialists, procedures and more from the comfort of your home. All you need to do is enter a keyword or phrase describing what you are looking for.
DOWNLOAD MEDEX ONE APP
MedEx is a one-stop digital care navigation concierge backed by physical infrastructure, owning the patient experience and decentralizing the care continuum across Asia—integrating provider aggregation, satellite clinics, telemedicine, and at-home care.
MedEx is a one-stop digital care navigation concierge backed by physical infrastructure, owning the patient experience and decentralizing the care continuum across Asia—integrating provider aggregation, satellite clinics, telemedicine, and at-home care.
© 2020-26 MedEx Ventures Co., Ltd.
